Upcoming EventsMore than 100,000 Americans died from a drug overdose during the 12-month period ending in April 2021, an increase of 28.5% from the same period the year before, according to the Centers for Disease Control and Prevention. Opioids—mainly synthetic opioids such as fentanyl—are currently the main driver of drug overdose deaths. “With more people abusing fentanyl, the risk of overdose has skyrocketed,” said Eli Brown, MD, a physician at the Montefiore Nyack Hospital Recovery Center and an emergency department physician at the Hospital.
A prescription medicine called naloxone (Narcan) attaches to opioid receptors in the brain, and reverses or blocks the effects of other opioids. Anyone who abuses opioids, as well as their close friends and family, should have a kit that includes Narcan nasal spray on hand and learn how to use it, Dr. Brown advised. “Narcan is lifesaving, and it’s simple to use,” he said. It is safe, and can cause no harm, he noted.
When a person is overdosing on an opioid, such as heroin or fentanyl, their breathing can slow down or stop, and it can be very hard to wake up or revive them. “Opioids cause oxygen levels to plummet. Normally, if your oxygen levels drop your brain recognizes it and you breathe more heavily to compensate,” Dr. Brown said. “Opioids block the body’s reflex that increases breathing when you have low oxygen levels.” Giving Narcan rapidly reverses the effects of opioid drugs, restoring normal breathing.
Fentanyl is especially dangerous because it works more quickly than heroin. Fentanyl causes oxygen levels to plummet within minutes, which can cause a person to stop breathing and die, Dr. Brown said. “That’s why it’s so important for a person overdosing from fentanyl to be revived with Narcan quickly.”
How to Get Narcan
Anyone can get a Narcan kit from a pharmacy. Many pharmacies provide training in how to use the kit, Dr. Brown said. “The nasal spray is simple to use, but it’s useful to go through the training,” he said. “For instance, the training will explain what to do if you use one Narcan dose and it doesn’t work—which can happen with a fentanyl overdose. You are supposed to wait three minutes and then give another dose. The revived person can become agitated because Narcan causes opioid withdrawal symptoms, so the training goes over how to manage such circumstances.”
The kit also contains a face mask that can be used to provide rescue breathing if a person is not revived after dispensing Narcan, until emergency responders arrive. Narcan doesn’t take the place of emergency medical care, Dr. Brown said. Get emergency medical help right away after the first dose of Narcan, even if the person wakes up.
It’s important to note that the New York State 911 Good Samaritan Law allows people to call 911 without fear of arrest if they are having a drug or alcohol overdose that requires emergency medical care or if they witness someone overdosing.
Prescription Opioids
People taking long-term prescription opioids may also want to have a Narcan kit at home, in case someone in the home (including a teen or child) comes across the pills and overdoses, Dr. Brown said. To avoid this danger, keep prescription opioids in a locked cabinet, away from children, and be aware of signs and symptoms of an opioid overdose.
These can include:
- Unusual sleepiness or unresponsiveness
- Breathing will be slow or absent
- Slow heartbeat or low blood pressure
- Skin feels cold and clammy
- Pupils are tiny
- Nails and lips are blue
“A person who abuses opioids is often ashamed of their drug use and keeps it a secret,” Dr. Brown said. “It’s very important for a person using illicit opioids to tell others, so they can take steps such as having Narcan on hand.”
